Radiofrequency Ablation a Safe and Effective Treatment for Pediatric Benign Nodular Thyroid Goiter

Purpose: To evaluate the effectiveness of radiofrequency ablation (RFA) for benign thyroid nodules in pediatric patients.Materials and Methods: Twelve pediatric patients (11 female, 1 male; mean age 15.54 ± 2.8 years, range 10–19 years) with benign thyroid nodules (mean longest diameter 4.1 ± 1.4 cm, range 1.5–5.9 cm) treated by RFA from 2017 to 2020 were evaluated. The inclusion criteria for RFA therapy were (i) age < 20 years; (ii) benign cytological confirmation by 2 separate ultrasound guided fine-needle aspiration cytology (FNAC) or core needle biopsies; (iii) pressure symptoms or cosmetic problems caused by thyroid nodules; (iv) absence of any sonographic suspicious feature; and (v) follow-up for >6 months. Under local anesthesia, RFA was performed with the use of an RF generator and an 18-gauge internally cooled electrode. Volume changes in nodules on follow-up ultrasonography (US), changes in symptomatic and cosmetic scores, and complications arising during or after RFA were evaluated.Results: Mean follow-up period was 24.9 ± 13.9 months (range 6–43 months). At the last follow-up visits, volume of the nodule had decreased significantly (15.34 ± 11.52 mL vs. 4.07 ± 4.99 mL; P < 0.05), whereas volume reduction rate was 74.31% ± 19.59%. Both cosmetic and compressive symptoms were also significantly improved (2.91 ± 0.79 vs. 0.92 ± 0.67 and 1.5 ± 1.93 vs. 0.17 ± 0.39; P < 0.05). The mean number of ablation sessions was 1.4 ± 0.6 (range 1–3 sessions), and one of the patients suffered from transient vocal cord palsy which was spontaneously resolved 53 days later.Conclusions: RFA is a safe and effective treatment for benign thyroid nodules in pediatric patients, and can thus serve as an alternative treatment for thyroidectomy.

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Efficacy and safety of radiofrequency ablation for benign thyroid nodules in patients with previous thyroid lobectomy

BMC Medical Imaging ◽

10.1186/s12880-021-00577-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lin Yan ◽

Mingbo Zhang ◽

Fang Xie ◽

Jun Ma ◽

Jing Xiao ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Symptom Score ◽

Thyroid Function ◽

Thyroid Nodules ◽

Efficacy And Safety ◽

Thyroid Lobectomy ◽

The Mean ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Abstract Background Radiofrequency ablation (RFA) is recommended for the treatment of benign thyroid nodules. However, data on the clinical role of RFA for benign thyroid nodules in patients with history of thyroid lobectomy are insufficient. The purpose of this study was to evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign thyroid nodules in patients who had previously undergoing thyroid lobectomy. Methods From May 2015 to October 2018, a total of 20 patients (19 females, 1 male, mean age 49.50 ± 14.26 years, range 22–74 years) with 20 benign thyroid nodules (mean volume 15.04 ± 21.17 ml, range 0.40–69.67 ml) who had undergone previous thyroid lobectomy were included in this retrospective study. Patients were followed up at 3, 6, 12 months after RFA and every 12 months thereafter by ultrasound, clinical evaluation and thyroid function. Volume, volume reduction rate (VRR), symptom score and cosmetic score were evaluated. Results During the mean follow-up time of 21.24 ± 16.41 months, the mean nodule volume decreased significantly from 15.04 ± 21.17 ml to 1.29 ± 1.17 ml (P = 0.018) with a mean VRR of 85.41 ± 12.17%. Therapeutic success was achieved in a single session for all thyroid nodules. The symptom score (P = 0.001) and cosmetic score (P = 0.001) were both significantly reduced at the last follow-up. The levels of free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone were not significantly different at the last follow-up from those prior to treatment (all P > 0.05). No life-threatening complications or sequelae occurred after RFA. Conclusions As a minimally invasive modality, RFA was a safe, effective, and thyroid function-preserving option for patients with symptomatic benign thyroid nodules after a previous lobectomy.

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Follow-up of Benign Thyroid Nodules—Can We Do Less?

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2018.10.001 ◽

2019 ◽

Vol 70 (1) ◽

pp. 62-67 ◽

Cited By ~ 1

Author(s):

Manijeh Mohammadi ◽

Carrie Betel ◽

Kirsteen Rennie Burton ◽

Kevin McLughlin Higgins ◽

Zeina Ghorab ◽

...

Keyword(s):

Fine Needle Aspiration ◽

Thyroid Nodules ◽

Descriptive Study ◽

Needle Aspiration ◽

Thyroid Malignancy ◽

Fine Needle ◽

Nodule Size ◽

Benign Thyroid Nodules ◽

Benign Thyroid

Objective To determine the incidence of malignancy, follow-up ultrasound (US), and repeat fine needle aspiration (FNA) in thyroid nodules that have been previously biopsied as benign. Methods This is a retrospective, descriptive study of benign thyroid nodules evaluated by US between 2010-2011. We determined the frequency of follow-up ultrasounds and FNAs, mean years of follow-up, interval between follow-up US, change in nodule size, reasons for repeat FNA (rFNA), frequency of thyroidectomy, and thyroid malignancy during 5 years of follow-up. Results A total of 733 benign thyroid nodules were reviewed in 615 patients. Mean years of US follow-up was 3.47 ± 1.65 years; 275 (37.5%) had no follow-up US; 109 (14.9%) had 1 follow-up US; 93 (12.7%) had 2 follow-up US; and 256 (34.9%) had 3 or more follow-up US. Assessment of thyroid nodule size showed that 215 (28.8%) nodules decreased in size, 145 (19.4%) increased in size by less than 50%, and 91 (12.1%) increased in size by more than 50%. Of the 733 nodules, 17 nodules (2.3%) underwent thyroidectomy for which the pathology result of 9 (1.2%) showed malignancy, and 65 (8.9%) thyroid nodules underwent rFNA. When applying the 2015 recommendations for repeat FNA, 35% were done unnecessarily. Conclusion In our sample of initially benign thyroid nodules, only 9 patients (1.2%) had pathology-proven malignancy after a mean follow-up of 3.5 years. Over 30% of patients had more than 3 rUSs. Decreased interval and frequency of rUS should be considered in future guidelines for thyroid management.

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Radiofrequency ablation of benign thyroid nodules: safety and imaging follow-up in 236 patients

European Radiology ◽

10.1007/s00330-008-0880-6 ◽

2008 ◽

Vol 18 (6) ◽

pp. 1244-1250 ◽

Cited By ~ 224

Author(s):

Woo Kyoung Jeong ◽

Jung Hwan Baek ◽

Hyunchul Rhim ◽

Yoon Suk Kim ◽

Min Sook Kwak ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Management of bleeding associated with radiofrequency ablation of benign thyroid nodules

Journal of International Medical Research ◽

10.1177/0300060520937526 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093752

Author(s):

Kunpeng Hu ◽

Yufan Lian ◽

Jinfen Wang ◽

Wenchao Li ◽

Zhicheng Yao ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Effective Management ◽

Voice Change ◽

Life Threatening ◽

The Mean ◽

Benign Thyroid Nodules ◽

Benign Thyroid ◽

Clinical Strategy

Objective This study was performed to explore the effective management of bleeding associated with radiofrequency ablation (RFA) of benign thyroid nodules. Methods Thirty-five patients with benign thyroid nodules who were treated with ultrasound-guided RFA from July 2015 to December 2016 at the Third Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed. The technique efficacy, bleeding, and other complications were assessed during the follow-up period. Results The mean technique efficacy was 55.6%±22.8% at 1 month and 24.1%±17.1% at 6 months after the procedure. One case of an intranodular haematoma and two cases of voice change (>1 month) were observed. All patients recovered with corresponding treatment. Conclusion Although the incidence of haemorrhage is low, serious haematomas are life-threatening. Therefore, having a comprehensive understanding of the potential complications, an accurate clinical strategy, and adequate technical skills may prevent or help to properly manage these complications.

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Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients

Experimental Biology and Medicine ◽

10.1177/1535370217727477 ◽

2017 ◽

Vol 242 (15) ◽

pp. 1515-1523 ◽

Cited By ~ 21

Author(s):

Yu-Jiang Liu ◽

Lin-Xue Qian ◽

Dong Liu ◽

Jun-Feng Zhao

Keyword(s):

Microwave Ablation ◽

Thyroid Nodules ◽

Reduction Rate ◽

Volume Reduction ◽

Ultrasound Guided ◽

Nodule Volume ◽

Safe Technique ◽

Benign Thyroid Nodules ◽

Benign Thyroid

The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P < 0.05). The pretreatment volume of nodules was positively correlated with the final volume reduction rate at final follow-up ( P = 0.004). No serious complications were observed after treatment. In conclusion, ultrasound-guided microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients’ clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

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Predictor Analysis in Radiofrequency Ablation of Benign Thyroid Nodules: A Single Center Experience

Frontiers in Endocrinology ◽

10.3389/fendo.2021.638880 ◽

2021 ◽

Vol 12 ◽

Author(s):

Alessandro Bisceglia ◽

Ruth Rossetto ◽

Sara Garberoglio ◽

Angelica Franzin ◽

Alice Cerato ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Neck Circumference ◽

Volume Reduction ◽

Single Center ◽

Treatment Volume ◽

Pre Treatment ◽

Benign Thyroid Nodules ◽

Benign Thyroid

PurposeTo confirm the efficacy of ultrasound (US) guided radiofrequency ablation (RFA) in the treatment of benign thyroid nodules, we evaluated as primary outcome the technical efficacy and clinical success in a single center dataset. The secondary outcome was to find a correlation between nodules’ pre-treatment features and volume reduction rate (VRR) ≥75% at 12 months after RFA and during follow-up period.MethodsThis retrospective study included 119 consecutive patients (99 females, 20 males, 51.5 ± 14.4 years) with benign thyroid nodules treated in our hospital between October 2014 and December 2018 with a mean follow-up of 26.8 months (range 3–48). Clinical and US features before and after RFA were evaluated by a US examination at 1, 3, 6, 12 months and annually thereafter up to 48 months.ResultsThe median pre-treatment volume was 22.4 ml; after RFA we observed a statistically significant volume reduction from the first month (11.7 ml) to the last follow-up (p < 0.001 for all follow-up times). The median VRR was 47.1, 55.3, 61.2, 67.6, 72.8, 71.3, and 62.9% at 1, 3, 6, 12, 24, 36, and 48 months of follow-up respectively, showing a progressive significant improvement up to 24 months (VRRs 1 vs 3 months, 3 vs 6 months and 6 vs 12 months p < 0.001, 12 vs 24 months p = 0.05) while no differences at 24 vs 36 and 36 vs 48 months were observed. Symptoms improved significantly (complete resolution 64.35%, partial resolution 35.65%), and neck circumference was reduced as compared to pre-treatment (p < 0.001). Lower pre-treatment neck circumference (37.5 vs 36.0 cm, p = 0.01) was a positive predictor of VRR ≥75% at 12 months. Macrocystic echostructure (HR 2.48, p 0.046) and pre-treatment volume >22.4 ml (HR 0.54, p 0.036) were found to be independent positive and negative predictors of VRR ≥75% respectively. One-month post RFA VRR ≥50% represented the best positive predictor of technical success.ConclusionsThis study confirmed the efficacy of RFA in the treatment of benign thyroid nodules. In particular we show that by selecting macrocystic nodules smaller than 22.4 ml better long-term response can be achieved, which is predicted by an early shrinkage of the nodule.

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Long-Term Results of Ultrasound-Guided Radiofrequency Ablation of Benign Thyroid Nodules: State of the Art and Future Perspectives—A Systematic Review

Frontiers in Endocrinology ◽

10.3389/fendo.2021.622996 ◽

2021 ◽

Vol 12 ◽

Author(s):

Hervé Monpeyssen ◽

Ahmad Alamri ◽

Adrien Ben Hamou

Keyword(s):

Systematic Review ◽

Radiofrequency Ablation ◽

Thyroid Nodules ◽

Long Term Results ◽

Future Perspectives ◽

Time Duration ◽

Benign Thyroid Nodules ◽

Benign Thyroid

BackgroundNearly 20 years after the first feasibility study, minimally invasive ultrasound (US)-guided therapeutic techniques are now considered as a safe and effective alternative to surgery for symptomatic benign thyroid nodules. Radiofrequency ablation (RFA) is one of the most widely used treatment in specialized thyroid centers but, due to the relatively recent introduction into clinical practice, there are limited long-term follow-up studies. Aim of our work was to review the outcomes of RFA on solid nonfunctioning and on autonomous thyroid nodules (AFTN) on a long-time period for assessing the results in term of efficacy, complications, and costs and to compare them to the current indications of RFA.MethodsA systematic review was performed using EMBASE and Medline library data between 2008 and 2021. Seventeen studies evaluated RFA for the treatment of benign solid (nonfunctioning or autonomous) thyroid nodules, with an at least 18 months of follow-up. Data extraction and quality assessment were performed by two endocrinologist according to PRISMA guidelines. Anthropometric data, safety and efficacy parameters were collected.ResultsThe majority of the studies was retrospective study and reported 933 nodules, mostly solid. Baseline volume ranged between 6.1 ± 9.6 and 36.3 ± 59.8 ml. Local analgesia was used and the time duration of the treatment was between 5 ± 2 and 22.1 ± 10.9 min. The volume reduction rate at 12 months ranged from 67% to 75% for the nodule treated with a single procedure and reached to 93.6 ± 9.7% for nodules treated with repeat ablations. The regrowth rate at 12 months ranged from 0% to 34%.ConclusionAll the studies under examination consistently validated the long-term clinical efficacy and the substantial safety of RFA for the treatment of benign thyroid nodules. Thermal ablation, however, is an operator-dependent technique and should be performed in centers with specific expertise. The selection of the patients should be rigorous because the nodule size and the structural and functional characteristics influence the appropriateness and the outcomes of the treatment. Future perspectives as the treatment of micro-papillary thyroid cancer or cervical recurrence need further investigations.

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